Comparing the efficacy of periprostatic nerve block alone versus periprostatic nerve block plus oral tramadol plus paracetamol tablet for pain control of patients during and after transrectal biopsy of the prostate gland: A randomized controlled trial

OBJECTIVE@#To compare the efficacy of periprostatic nerve block (PPNB) alone versus periprostatic nerve block plus oral Tramadol+Paracetamol Tablet for pain control during and after transrectal ultrasound-guided (TRUS) biopsy of the prostate gland.@*METHODS@#This was a double-blind, placebo-controlled randomized clinical trial. The authors randomized 40 male patients each to either PPNB or PPNB plus oral tramadol and paracetamol (37.5mg/325mg) an hour prior to prostate biopsy. A ten-point visual analog scale was used to measure pain intensity and was recorded upon insertion of the ultrasound probe, during the biopsy, and one hour after the procedure.@*RESULTS@#The two groups were similar in terms of baseline characteristics. Reductions in pain scores were statistically significantly different (p<.001) for each group when comparing pain from at point of insertion of the probe versus during biopsy and versus one-hour post-operatively. However, when comparing the two groups, the pain scores were not statistically significantly different upon insertion of the probe (p=.68), during the biopsy (p=.26) and one-hour post-operatively (p=.54).@*CONCLUSION@#Tramadol and paracetamol combination in addition to periprostatic nerve block produces pain relief similar to standard periprostatic nerve block alone.

Bladder endometriosis presenting as obstructive uropathy in a post-hysterectomy patient

@#Urinary tract endometriosis is present in approximately 1% of women. Bladder endometriosis (BE) is defined as presence of endometrial glands and stroma in the detrusor muscle. Close collaboration of the urologists and gynecologists in dealing with urinary tract endometriosis is necessary in order to establish both the correct diagnostic procedure and the most adequate management. Presented here is the case of a 42-year old female, G3P3 (3003), who presented with intermittent episodes of right-sided flank pain four months post-hysterectomy. She was initially diagnosed to have a bladder tumor and underwent transurethral resection of bladder tumor. Histopathological examination of the resected specimen revealed endometriosis.